000087831 001__ 87831
000087831 005__ 20231027130637.0
000087831 0247_ $$2doi$$a10.1016/j.ijcard.2018.01.067
000087831 0248_ $$2sideral$$a105392
000087831 037__ $$aART-2018-105392
000087831 041__ $$aeng
000087831 100__ $$0(orcid)0000-0002-4769-7154$$aRubio-Gracia, Jorge$$uUniversidad de Zaragoza
000087831 245__ $$aPrevalence, predictors and clinical outcome of residual congestion in acute decompensated heart failure
000087831 260__ $$c2018
000087831 5060_ $$aAccess copy available to the general public$$fUnrestricted
000087831 5203_ $$aBackground: Congestion is the main reason for hospital admission for acute decompensated heart failure (ADHF). A better understanding of the clinical course of congestion and factors associated with decongestion are therefore important. We studied the clinical course, predictors and prognostic value of congestion in a cohort of patients admitted for ADHF by including different indirect markers of congestion (residual clinical congestion, brain natriuretic peptides (BNP) trajectories, hemoconcentration or diuretic response). Methods and results: We studied the prognostic value of residual clinical congestion using an established composite congestion score (CCS) in 1572 ADHF patients. At baseline, 1528 (97.2%) patients were significantly congested (CCS = 3), after 7 days of hospitalization or discharge (whichever came first), 451 (28.7%) patients were still significantly congested (CCS = 3), 751 (47.8%) patients were mildly congested (CCS = 1 or 2) and 370 (23.5%) patients had no signs of residual congestion (CCS = 0). The presence of significant residual congestion at day 7 or discharge was independently associated with increased risk of re-admissions for heart failure by day 60 (HR [95%CI] = 1.88 [1.39–2.55]) and all-cause mortality by day 180 (HR [95%CI] = 1.54 [1.16–2.04]). Diuretic response provided added prognostic value on top of residual congestion and baseline predictors for both outcomes, yet gain in prognostic performance was modest. Conclusion: Most patients with acute decompensated heart failure still have residual congestion 7 days after hospitalization. This factor was associated with higher rates of re-hospitalization and death. Decongestion surrogates, such as diuretic response, added to residual congestion, are still significant predictors of outcomes, but they do not provide meaningful additive prognostic information.
000087831 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc-nd$$uhttp://creativecommons.org/licenses/by-nc-nd/3.0/es/
000087831 590__ $$a3.471$$b2018
000087831 591__ $$aCARDIAC & CARDIOVASCULAR SYSTEMS$$b48 / 135 = 0.356$$c2018$$dQ2$$eT2
000087831 592__ $$a0.99$$b2018
000087831 593__ $$aCardiology and Cardiovascular Medicine$$c2018$$dQ2
000087831 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/acceptedVersion
000087831 700__ $$aDemissei, B.G.
000087831 700__ $$ater Maaten, J.M.
000087831 700__ $$aCleland, J.G.
000087831 700__ $$aO''Connor, C.M.
000087831 700__ $$aMetra, M.
000087831 700__ $$aPonikowski, P.
000087831 700__ $$aTeerlink, J.R.
000087831 700__ $$aCotter, G.
000087831 700__ $$aDavison, B.A.
000087831 700__ $$aGivertz, M.M.
000087831 700__ $$aBloomfield, D.M.
000087831 700__ $$aDittrich, H.
000087831 700__ $$aDamman, K.
000087831 700__ $$0(orcid)0000-0003-2361-9941$$aPérez-Calvo, Juan I.$$uUniversidad de Zaragoza
000087831 700__ $$aVoors, A.A.
000087831 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000087831 773__ $$g258 (2018), 185-191$$pInt. j. cardiol.$$tINTERNATIONAL JOURNAL OF CARDIOLOGY$$x0167-5273
000087831 8564_ $$s322984$$uhttps://zaguan.unizar.es/record/87831/files/texto_completo.pdf$$yPostprint
000087831 8564_ $$s187641$$uhttps://zaguan.unizar.es/record/87831/files/texto_completo.jpg?subformat=icon$$xicon$$yPostprint
000087831 909CO $$ooai:zaguan.unizar.es:87831$$particulos$$pdriver
000087831 951__ $$a2023-10-27-12:53:00
000087831 980__ $$aARTICLE